ACT's Giving Program Application

ACT Corporate Giving

Application Form

The ACT Giving Program accepts applications each year from September 1 to June 1 of the following year or until the Giving Program budget is depleted. Organizations are eligible to receive funding from ACT once during each application cycle. Therefore, if an organization desires funding for more than one event or project in a given cycle, it should submit a single funding request for all events or projects rather than multiple requests throughout the year.

Fields marked with * are required.

Deadline for funding decision (please apply at least 60 days prior to deadline):*

deadline

Section 1: Applicant Information

Organization Name*

Organization type, e.g., 501(c)(3)*

Organization Type (If you selected "Other")

Street Address*

City*

State*

ZIP Code*

Tax Payer ID*

Organization Contact Name*

Organization Contact Position/Title*

Organization Contact Email*

Organization Contact Phone Number*

Alternate Contact Name*

Alternate Contact Position/Title*

Alternate Contact Email*

Alternate Contact Phone Number*

Section 2: Project Information

ACT has the sole discretion to determine what funding to provide, if any. Typically, those selected for funding request and receive less than $5,000.

Program/Project Title*

Number of Individuals Impacted by your Program/Project*

Program/Project Start Date*

Program/Project End Date*

Program/Project Location (address, city, state)

Total Program/Project Amount*

Amount Requested from ACT*

Other Sources of Funding (amounts to be provided by other sources in addition to amount being requested of ACT.)

Source Name

Source Amount

Status

Source Name

Source Amount

Status

Source Name

Source Amount

Status

Source Name

Source Amount

Status

Source Name

Source Amount

Status

Section 3: Project Description

Please refer to the guidelines regarding funding restrictions

Indicate which ACT Giving Interests are addressed by your program/project (check all that apply):*

Education and Workplace

Human and Social Needs

Community Betterment

Describe how your program/project aligns with ACT's commitment to equity:*

Will you use the ACT logo for promotion of your project/event?*

Yes

How did you hear about the ACT Corporate Giving Program (check at least one)?

ACT Website

Center for Equity in Learning Website

Social Media

ACT Employee

News Article

Previous Experience

Other

If an ACT Employee, please provide their name and involvement with your organization:

By submitting this application, you agree that:

The applying organization is, and will remain in, compliance with all federal, state, and local laws, rules, and regulations.
If funds are awarded, the applying organization will use the funding only for the purpose(s) described in the application.
The applying organization will not promote or engage in violence or terrorism, nor make sub-grants or give funding to any entity that engages in these activities.

Reminder

Please provide your organization’s IRS tax exemption determination letter and W-9. Send PDFs to corporate.giving@act.org.

ACT's Giving Program Application

Form submitted successfully

ACT Corporate Giving

Application Form

Section 1: Applicant Information

Section 2: Project Information

Section 3: Project Description

Reminder